PDF(Pubmed)
Abstract：
Expanding the concept of \"precision\" or \"personalized\" medicine, personalized health and precision public health designate the use of various kinds of data-genomic, other omics, clinical, or those produced by individuals themselves through self-tracking-to optimize health interventions benefiting the whole population. This paper draws on an ethnography of the implementation of a population-based environmental health cohort to shed light on the reconfigurations brought about by the \"personalization\" of public health in Switzerland. Combining human biomonitoring and molecular epidemiology, this cohort aims to advance the science of the exposome, a notion referring to the totality of exposures to which individuals are subjected over their lifecourse. Addressing the tension between holism and reductionism, this paper points to the important gap between the promissory horizon of the exposome and the realities of practices. Situations of reductionism are defined as moments of friction and negotiation between different rationales and values, exposing what makes the science of the exposome, including its material, economic, institutional, and methodological constraints, as well as its imaginaries and values. Rather than opposing holism and reductionism, I emphasize that they constitute two sides of the same coin, as they both pragmatically enable action and produce situated versions of the social. This empirical case shows how reductionism operates at the chemical, biological, and populational levels to produce public health scientific and social values. It thus contributes to contextualizing the pragmatic and strategic choices made by scientists, as well as the values they favor, in a research environment marked by the predominance of biomedicine over public health. It shows how the reductionism of the \"social environment\" was made for a better social integration of the cohort into the Swiss political and scientific landscape of public health. Bringing together actors involved in public health and questions of environmental exposures, this cohort can be interpreted as a biomedicalization of public health research, as well as an attempt to socialize it through the broad category of the exposome.
摘要：
扩大“精准”或“个性化”医学的概念，个性化健康和精准公共卫生指定使用各种数据基因组，其他组学，临床,或个人通过自我跟踪自己生产的产品-以优化健康干预措施，使整个人口受益。本文借鉴了基于人口的环境卫生队列实施的人种学，以阐明瑞士公共卫生的“个性化”带来的重新配置。结合人类生物监测和分子流行病学，这个群体的目的是推进曝光科学，一个概念，指的是个人在其一生中所遭受的全部风险。解决整体论和还原论之间的紧张关系，本文指出了曝光的预期范围与实践的现实之间的重要差距。还原论的情况被定义为不同理由和价值观之间的摩擦和谈判时刻，揭露是什么让科学的揭露变得更加科学，包括它的材料，经济,机构,和方法上的限制，以及它的想象力和价值观。与其反对整体论和还原论，我强调它们构成了同一枚硬币的两面，因为它们既务实地实现行动，又产生社会的定位版本。这个经验案例展示了还原论是如何在化学上运作的，生物，和人口水平，以产生公共卫生科学和社会价值。因此，它有助于将科学家做出的务实和战略选择进行情境化，以及他们喜欢的价值观，在以生物医学高于公共卫生为特征的研究环境中。它显示了“社会环境”的简化主义是如何使队列更好地融入瑞士公共卫生的政治和科学领域的社会。将参与公共卫生和环境暴露问题的参与者聚集在一起，这个队列可以解释为公共卫生研究的生物医学化，以及试图通过广泛的曝光类别将其社会化。
